When all this Covid-19 madness started, my first thought was that my clients are going to lose all the progress that we have made.  The majority of my clients are 65 and older, and most of them feel intimidated by the internet.  The thought of using a computer to exercise, forget it!  In fact, a few of them do not even have email addresses!  Crazy right?!  Well, not really.  None of us like to feel overwhelmed, dumb or frustrated.  Those feelings can be magnified by some Seniors when their friends having an easier time grasping the new world of computers and the internet. 

One observation that I have made during this time of quarantine about my senior clientele and the internet, they have many questions about all the phases that exist of accessing the internet.  They are certainly not dumb!  I don’t think anyone believes that.  However, I do believe that a lot of our Seniors feel as though there are too many complicated steps to access their exercise and trainers online.  Along with this belief, we must remember that our seniors did not grow up with text messaging, FaceTime and Xbox live.  They grew up in a time where real, face to face contact was the main way of communicating or a phone call.  If you’ve worked with Seniors, even if it's only a few clients, then you understand what I am saying.  Let’s just say, I have clients I can text and clients I need to call!  Honestly, I think our Seniors are on to something with the calls vs. texts, but that’s another subject for another time.

So how do we convince our Seniors to hop online (pun intended) and train with us via the internet?  I have found that by breaking down the process into phases, and then further breaking the phases down into simple steps allows for thorough understanding while limiting frustrations.  I have also discovered that when explaining virtual sessions in this particular blueprint, I inadvertently answer questions that a Senior may have, but doesn't necessarily want to ask for fear of feeling insecure and unknowledgeable.  Remember, for a lot of our Seniors, many responsibilities have been taken, or redirected from them (I.e. driving, cooking, etc.) for a number of reasons.  The last thing I want to do, is make someone feel as though this is one more thing they cannot do or understand.  This is the blueprint, or process, that I follow and that has had success with my clients.  The motivation to actually exercise, that’s up to you!  Lastly, both parties need to be PATIENT!  We all have loads of time right now, so lighten the mood, make a joke and relax. Remember, with every mistake made, you’re closer to the answer.

A few things to consider before you start...
-  You want them to pick a place that provides enough lighting so you can be seen by your trainer or client.  Typically, I like to use the natural light of the sun, so anywhere next to a window is great.  It is a good idea to have the camera facing away from the window so you can avoid any wash out that will make you appear dark.
-  Also, make sure you have plenty of room to move around and do the movements and exercises.

The Blueprint:

1. Power button: The computer has a power button. So does the platform you, as a trainer or Senior, choose to use for these virtual (online) sessions.  ZOOM, Skype or FaceTime are great platforms and there are many more similar ones out there.  I like to use ZOOM because they have a “free” option and it's super easy to access.  Learn how to turn the “power” on to the app or platform first.

2. Access (this is the hardest step for most):  There are a few steps we need to cover to access the session.  Now, the app is on and we need to get into the “room” or session so that we can see our trainer or instructor.
- Room numbers/codes:  Think of this as the address. This number or code is what we need to enter into the computer that will give us access to session.
- Video/Audio:  Hopefully, the default (original) settings are still set and not much needs to be done other than adjusting the volume to suit our needs. There are many tools available to both the trainer and the client such as YouTube and Google that can help us troubleshoot any issues and provide videos of the solutions.  Don’t hesitate to utilize one, or both for information.

3.  You've got the lights, the camera and now the action:  Now it's time to get moving!  Make sure the camera is adjusted so that you can be seen and heard clearly.

Good luck!  I hope that everyone is staying safe and healthy during these "quarantine days"!

You can find exercise videos and more information about Emeritus Health and Balance University at:
Website:
https://www.emeritushealthfitness.com/

YouTube:
https://www.youtube.com/channel/UCFZBCssysteSE_QDxsKa58w?view_as=subscriber

Facebook:
https://www.facebook.com/EmeritusHealthFitness/

What is the "Position Of Confidence" (POC)?  The POC is the very first position, or stance that I ask folks to try in Balance University, so that I can evaluate just how well, or poor, their balance may be.  The Split Stance, or known as "SS" in the Balance University program, is a great and safe way to introduce proprioception to a client.  Proprioception is a fancy term for "stable, but unstable environment".  So, if I stand on one foot, for many of us, that means that we will be a bit stable but mostly unstable in that particular position.  Proprioception is a key element to improving balance because it introduces the EXACT environment that enables better balance.  If you stand in the SS position, you may notice that your feet are wiggling side to side, as if you are standing on a block of ice trying to balance.  Believe it or not, this is a good thing!  However, please understand that we are all at different levels and the SS may not present much of a challenge to few, however, it can be quite the challenge to most.  Those of you that are not challenged much SS position, then try standing on one foot.  Even the most athletic folks must work a bit to stand on one foot whether they admit or not.

The point of focus with the POC position is to find that point in the SS that you feel 95%-100% confident that you will NOT fall.  This position will look different for everyone.  Some folks will have their feet really close, as though they are standing with their feet side by side.  Others may be able to move their feet further apart and have them placed more  narrow to create the POC.  Why is this important?  The POC will become a reference point as we move through the BU program and create the beginning of better balance, mobility and independence.

Tim Tebow is a great example as to how the POC will improve your confidence and balance.  Tim is a phenomenal athlete and quarterback.  Did you know that only .1% of all football players that play football in high school will become professional football players and play in the NFL.  One of the main reasons Tim Tebow is not playing Quarterback in the NFL is because of how long it takes him to get the ball out of his hand and throw the football.  If you will look at the pictures above, you will see the difference between Tim's motion and how low he drops his arm.  Then take a look at Aaron Rodgers and how low Aaron's arm is located during the throwing motion.  The differences may be subtle to some, however, in the game of football, seconds and inches can mean the difference between being open as a receiver or a being covered by a defender or defensive back. 

How many time do you think Tim Tebow has thrown a football this way?

When Tim sees an open receiver and wants to throw the football to them, do you think he is thinking, "elbow up, move arm back, drop arm, take a step back with the left foot, uh oh.... here comes a 367lb. lineman to tackle me!... RUN... ok... get set, drop arm, thumbs under.... etc."  ABSOLUTELY not!  Here's what happens, Tim sees an open receiver and he fires away!  In order for this to happen, the CEO (brain) receives a message from his eyes that tells him to flip the "throw the ball NOW switch".  This "switch" activates a series of muscle contractions from the feet, neck, shoulder, arm, core and legs that allows Tim to throw the ball without thinking about contracting each of those muscles individually.  In other words, Tim is not focused on his throwing motion, he is focused on making a determination on which receiver he should throw it too!
Why? 
Tim has thrown the ball this way his entire life and he has been able to develop and create a pattern or "button" for the CEO (brain).  He has created muscle memory that allows his CEO (brain) to flip a switch and the symphony of muscle contractions begins without much thought.  So, how many times would Tim need to throw the ball correctly in order to change his muscle memory and motion to mimick Aaron Rodgers motion and get the ball out of his hand much more quickly? 
The answer:
Tim would need to throw the ball correctly as many times as he has thrown the ball incorrectly, to get it right and establish a new pattern and "button" for the CEO to press.
 
The only way to improve one's balance is through consistent and repetitive work in proprioceptive environments just like the POC.  Balance University teaches it's students the correct way to establish neuromuscular efficiency and the correct patterns needed to create better balance.  There is not a secret movement or "magical" exercise, however, there is certainly a right order to the exercises needed to create a more balanced and independent person.

I want to prevent folks from falling, better known as "fall prevention", rather than deal with the repurcussions that follow like hospital and doctor visits!

This is a question I get quite often. Typically, it begins with me sitting with a potential client at a table in their home as they take advantage of our FREE, in-home assessment. We talk a bit about what their goals may be, what the expectations are, and then the question, "I've done physical therapy and that didn't seem to work very well, how is your program different?"

I love this question! The short answer is simple. Physical therapy is great and it does work for a lot of folks. The shortfall may come in the patients line of thinking. For some individuals, they will have very high, sometimes unrealistic, expecatations of where their balance should be at the end of three to four weeks. The problem with those types of expectations are solved by one statement my Uncle would say to me sometimes, "You can't walk into the woods five miles, turn around and expect to walk out in one!" Second, PT doesn't always address all of the under lying issues such as, lack of leg strength, poor posture and lack of flexibility. Any of these three issues will change the way the body is built to move. If you lack leg strength, you typically can't stand or walk for long periods of time. If your posture is not great and you hunch over, this changes your center of gravity and the way the body was built to align itself through movement. If you lack flexibility, this will prevent muscles (particularly the hamstrings) from moving through there entire range of motion they are responsible for moving through. This can shorten the gait length and force other muslces to pick up the "slack". Also, at the end of PT, the patient is given a sheet of exercises they are responsible for perfoming on a daily, or every other day schedule. By show of hands, how many of us have kept that schedule? That's what I thought!

It's funny how you always showed up for all of your PT appointments though. And you executed all the exercises, sets and reps. Most would even admit that therapy did work, at least a little bit. Then, your insurance stops covering your sessions and you get your sheet of exercises for you to do on your own. For most, they have great intentions but life gets in the way. There's golf, pickleball, The Price is Right, happy hour and then hair appointments... the list goes on!

Balance University forces you to show up to a one-hour class, one time per week for 45-60 minutes. The cost is only $99 ($9.90/class) and you will be guided through the program by a Balance University certified trainer (at the moment, we do not accept insurance.). So, to answer the question, why should you try Balance University, even though you've tried physical therapy because:

1. Balance University is built on four core pillars: improve leg strength (which is a life indicator), improve posture, increase flexibility and balance exercises. We focus on the entire problem, not just balance. We fix the underlying issues.
2. The BU course lasts 10-weeks, not three or four.
3. The program focuses on neuromuscular efficiency. That's a fancy term we use so that people think us "experts" know what we're talking about. Neuromuscular efficiency is the communication network between the brain and the muscles. The more you work on their "marriage", the better they will communicate, the better balance and life you will have!
4. You don't have to deal with insurance!
5. You can take the 10-week course over and over again. You could possibly end up with two or more doctorate's in balance!
6. The BU program can be modified for anyone in any condition. From healthy on two feet to wheelchair or bed bound. This program has alternative exercises to make everyone successful.
7. BU is a progressive program. The next week is always tougher and more challenging than the previous.
8. You do NOT need a bunch of fancy, expensive equipment to complete the program.
9. BU helps improve osteoporosis by utilizing many of the same exercises that you would find on the Osteoporosis Foundation’s website.
10. Instead of just a sheet with exercises, BU is a book that gives you the "what's next" exercise. So, after you have mastered a exercise, there's no guessing on what to do next. Just flip to the following week.

I would love for everyone 65 and older to go through the Balance University program! It will help you stay mobile, independent and healthy!

Do want to know the most common question that I am asked from people?  It doesn't matter what the venue or how big or small the group I'm speaking to, inevitably, I get the same question everywhere I go. 

The question?  "Why am I able to balance better on one foot than the other?"

I am willing to bet that we all have experienced this, or most of us have in some capacity.  So, what is the reason for this phenomenon?  It's not exactly a short answer, however, I do have one.

I have asked many healthcare professionals regarding this issue.  I have spoken to physicians, therapists, colleagues and everyone else that I thought would have some knowledge as to why we all seem to have a side that we are better with balancing than another.  What is more baffling, it's not always the dominant side!  Now explain that?!  No one seems to have a scientific answer to this question.

So, here's what I know...  For the last seven years, I have observed folks and how they stand, walk, shift their weight from side-to-side and move overall.  Also, I have watched people who are standing and in casual conversation and how they shift their weight and position themselves when talking.  When most folks are talking and standing, possibly with a freind in a casual conversation, they will stand with the majority of their weight shifted to one side or another.  This results with one side becoming more comfortable handling 70%-80% of your bodyweight, while the other side is not.  So, it's not much of a stretch to shift 100% of your bodyweight to that particular side and your body feeling equipped, comfortable and strong enough to handle the weight versus the other side.  The muscles in your leg become stronger and joints become better equiped to handle the entire load of your body.  Also, your brain (nervous system) and all the muscles (muscular system) involved in maintaining that particular position create a significant amount of nueromuscular effeciency.  This means that the pathways between you brain and muscles create a great and very effecient communication network that allows you to maintain that shifted position with ease so you can focus more on the content of your conversation rather than balancing on one side. 

Here is something fun to do.  Start watching your friends and family when you talk with them and both of you are  standing.  Could you identify which side they would have an easier time standing and balancing with on one foot?